Prof. Nicholas Harvey's presentation from Osteoporosis 2016: Calcium, with or without vitamin D supplementation, is not associated with ischaemic heart disease or cardiac death: the UK Biobank cohort. Find out more at: https://nos.org.uk/conference

1. Calcium and vitamin D supplementation
are not associated with ischaemic heart
disease: Findings from the UK Biobank
cohort
Nicholas C Harvey1,2, Stefania D’Angelo1, Julien Paccou1,3,
Mark Edwards1, Steffen E Petersen4, Cyrus Cooper1,3,5
1MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; 2Université Lille Nord-de-France, Lille,
France;3NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital
Southampton NHS Foundation Trust, Southampton, UK; 4NIHR Musculoskeletal Biomedical Research Unit, University of
Oxford, Oxford, UK; 5NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen
Mary University of London

2. Background
• Calcium +/- vitamin D supplementation
commonly used1
• Concern over links to cardiovascular
outcomes, but inconsistent evidence2-5
• Calcification involved in atherosclerosis, but
direct mechanistic link unproven5,6
• Limited data at population level
1Rizzoli et al., CRMO 2013
2Bolland et al., BMJ 2010
3Bolland et al., BMJ 2011
4Lewis et al., JBMR 2015
5Harvey et al., Osteoporos Int 2016 (in press)
6Heaney et al., Adv. Nutr. 2012

3. Aim
• Evaluate any link between calcium +/- vitamin
D supplementation and cardiovascular
outcomes in a UK population-based study

4. Methods
• 502,664 men and women aged 40-69 years
• Supplement data from questionnaire
• HES linkage (ICD-10): Hospital admission for
ischaemic heart disease and all CVD
• ONS linkage for death information
• Cox models; Adjustment for age, BMI, smoking,
alcohol, educational level, vigorous physical activity,
systolic blood pressure, diabetes/cholesterol
medication, HRT use (in women)
• n=486,522, yielding 1,962,642 total person-years

5. Baseline characteristics
Demographic characteristics Females Males
Age (median(IQR)) 57.0 (50.0-63.0) 58.0 (50.0-63.0)
BMI (mean(SD)) 27.1 (5.2) 27.8 (4.2)
White ethnicity (%) 94.4% 94.2%
College or University degree 38.2% 41.8%
Alcohol intake>= 3 times per week 37.0% 51.9%
Smoking (%)
Never 59.5% 49.5%
Ex 31.1% 37.4%
Current 8.9% 12.5%
On calcium supplements (%) 10.6% 2.6%
On vitamin D supplements (%) 5.2% 2.5%
On both (%) 3.5% 0.8%
Physical activity (days a week) (median (IQR)) 1.0 (0-3.0) 2.0 (0-3.0)
Systolic blood pressure 135.3 (19.2) 141.2 (17.4)
Medication for cholesterol/diabetes (%) 11.6% 19.3%
Medication for hypertension (%) 16.8% 21.9%

6. Calcium +/- vitamin D supplementation
and IHD in UK Biobank
Total admissions with IHD
men = 3,425; women = 1,387
Total admissions with any CVD
men = 3,880; women = 1,684
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Hospital admission with IHD
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7. Calcium +/- vitamin D supplementation
and death in UK Biobank
Total deaths from IHD
men = 689 ; women = 147
Total deaths from any CVD
men = 771 ; women = 179
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8. Conclusions
• Use of calcium supplementation was not associated
with increased risk of ischaemic or non-ischaemic
cardiovascular events leading to hospital admission
or death
• These findings support the cardiovascular safety of
calcium and vitamin D supplementation, at least
within the age range studied
• This research has been conducted using the UK Biobank Resource.

9. Calcium and vitamin D supplementation
are not associated with ischaemic heart
disease: Findings from the UK Biobank
cohort
Nicholas C Harvey1,2, Stefania D’Angelo1, Julien Paccou1,3,
Mark Edwards1, Steffen E Petersen4, Cyrus Cooper1,3,5
1MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; 2Université Lille Nord-de-France, Lille,
France;3NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital
Southampton NHS Foundation Trust, Southampton, UK; 4NIHR Musculoskeletal Biomedical Research Unit, University of
Oxford, Oxford, UK; 5NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen
Mary University of London